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Supporting Your Journey

Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.

Dear Patients,

I created this forum to welcome any questions you have on the topic of infertility, IVF, conception, testing, evaluation, or any related topics. I do my best to answer all questions in less than 24 hours. I know your question is important and, in many cases, I will answer within just a few hours. Thank you for taking the time to trust me with your concern.

– Geoffrey Sher, MD

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226 answers

Embryos & Genetic Testing

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Embryos & Genetic Testing Apr 22, 2024

Mosaic transfer

Hi!! I have a grade 422 low level mosaic. Specifically, it says 46, XY, -Yp (x0, mos, ~40%), -14 (x1, mos, ~50%). What are my real options to have a healthy/sick baby if I get it transferred? Thank you so… — Xiomara R.

Dr. Geoffrey Sher answered

Human embryo development is a marvel of intricate processes, including reprogramming, sequential cleavage divisions, mitotic chromosome segregation, and embryonic genome activation. However, the journey towards a successful pregnancy is not without its challenges, as chromosomal abnormalities can occur during germ cell and preimplantation embryo development, leading to early…
Cost & Insurance Apr 17, 2024

FET inquiry

Hi, My wife and I are doing IVF in Canada and going to transfer embryos to United States for surrogacy. Can I know the cost estimation of FET at your clinic? (including fees to receive embryos from other clinics, FDA… — Ziyi W.

Dr. Geoffrey Sher answered

Please call Jessie at SFS in New York (646-792-7476) for this information. Geoff Sher
Embryos & Genetic Testing Apr 15, 2024

HLA matching

Hello, I compared the markers of different HLA genes between myself and my husband from our raw genetic data which was produced by 23andMe and I found the following: 1. HLA-A: 3/3 markers matched = 100% 2. HLA-B: 2/4 markers… — Holly S.

Dr. Geoffrey Sher answered

This is too complex for me to respond to authoritatively here. I request that you call my assistant, Patti Converse (702-533-2691) and set up an online consultation with me to discuss. Geoff Sher
Embryos & Genetic Testing Apr 10, 2024

Frozen Donor eggs and no blastocysts

Dear Dr. Sher, Im 37 years old with long story of 15 natural chemical pregnancies and after one ovarian stimulation with my oen eggs but with no blastocysts in October 2023 I decided to go through frozen donor eggs from… — Ola C.

Dr. Geoffrey Sher answered

I think we should talk. Please call my assistant, Patti Converse (702-533-2691) and set up an online consultation with me to discuss in depth. UNDERSTANDING RECURRENT PREGNANCY LOSS ( RPL): CAUSES AND SOLUTIONS. When it comes to reproduction, humans face challenges compared to other mammals. A significant number…
Embryos & Genetic Testing Apr 9, 2024

Recurrent biochemical & Ectopic

Hi Dr Sher, Could you please try and answer what could be causing my issue and possible solution. I am 38 (husband 40) and we are married for 13 years; trying for a child since 10 years. I never had… — Indira V.

Dr. Geoffrey Sher answered

When it comes to reproduction, humans face challenges compared to other mammals. A significant number of fertilized eggs in humans do not result in live births, with up to 75% failing to develop, and around 30% of pregnancies ending within the first 10 weeks (first trimester). Recurrent pregnancy…
Embryos & Genetic Testing Apr 1, 2024

Pregnancy and embryo

I was sexually active march 4th and had unprotected sex… no seman got inside of me.i tested myself on the 18 got a negative and than got my embryo transfer on the 18 tested myself on the 19,20,21 Got a… — Jaylin W.

Dr. Geoffrey Sher answered

You tested too early! I suggest you test again now. That will give a more definitive result! Geoff Sher
Embryos & Genetic Testing Mar 25, 2024

IVF Failure/ embryo issue

Hello Dr. Sher, I just watched a video of your interview with Dr. Aimee regarding RIF. I am age 36 with 5 failed to implant IUI's and 2 IVF retrievals with donor sperm. Prior to now I never tried to… — Michelle D.

Dr. Geoffrey Sher answered

ADDRESSING DIMINISHING OVARIAN RESERVE (DOR) IN IVF Understanding the impact of ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation protocols…
Embryos & Genetic Testing Mar 18, 2024

Double Ovidrel! dosage and low BMI

Dear Dr. Sher, I am 43 years old, and due to the high rate of aneuploidy in the previous two attempts, and following your teachings, I convinced my doctor not to use Decapeptyl in the dual trigger, but only Ovidrel… — Anne C.

Dr. Geoffrey Sher answered

I really cannot suggest how to approach your doctor on this matter! So sorry! Geoff Sher
Embryos & Genetic Testing Mar 15, 2024

Recurrent Implantation Failure

Hello Dr. Sher at my current clinic I have gone through 4 transfers with PGT-A normal embryos. My first transfer resulted in a chemical pregnancy, but the following transfers did not implant at all. The tests I have done are… — Ashley P.

Dr. Geoffrey Sher answered

In my opinion this is almost certainly an implantation dysfunction. Bear in mind that in 30% of cases, endometriosis is associated with an immunologic implantation dysfunction. Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or…
Age & Fertility Mar 12, 2024

Advanced age IVF Cost

I like to know the cost of IVF treatment at your centre. I am 42 and I have had to genetically tested embryo's. My first IVF was done in India. The first frozen embryo transfer failed. Before trying another FET… — Neha S.

Dr. Drew Tortoriello answered

Please contact my assistant, Patti for information on cost (702-533-2691). Below is some information for your interest. ADDRESSING ADVANCING AGE AND DIMINISHING OVARIAN RESERVE (DOR) IN IVF Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes…
Embryos & Genetic Testing Mar 4, 2024

Failed donor embryo FET

Hi there, I hope you are well. I had failed pgs tested 3AA embryo donation. Era receptive microbiom recently tested lactobacillus — Private

Dr. Geoffrey Sher answered

Understanding the impact of age and ovarian reserve on the success of in vitro fertilization (IVF) is crucial when it comes to reproductive health. This article aims to simplify and clarify these concepts, emphasizing their significance in the selection of ovarian stimulation protocols for IVF. By providing you…
Egg Health & Ovarian Reserve Feb 20, 2024

IVF consultation

1.3, 2.1cm Trigger was 10000 IU Gonasi HP (hCG) and on day 11. Only 1 mature egg was retrieved, and fertilised using ICSI. My day 3 update is a slow growing embryo of 3 cells with some fragmentation. I don't… — Vessie V.

Dr. Geoffrey Sher answered

"Empowering Choices: Embryo Banking vs. Egg Banking for Fertility Preservation" It's crucial for women to make informed decisions about preserving their fertility. Delaying trying to conceive, relying on egg freezing, or assuming the biological clock can be paused are misconceptions. As women age, egg quality declines, affecting the…
Embryos & Genetic Testing Feb 16, 2024

High TNF alpha

What is the recommended transfer protocol for someone with high TNF Alpha. I was given prednisone but it did not work. Prior to transfer it was 45.0 and I was prescribed 25mg prednisone for a month but it increased to… — Private

Dr. Geoffrey Sher answered

Elevated TNF alpha indicates activated natural killer cell activity. A RATIONAL BASIS FOR MANAGEMENT OF IMMUNOLOGIC CAUSES OF EMBRYO IMPLANTATION DYSFUNCTION In the world of assisted reproduction, when IVF fails repeatedly or without explanation, it's often assumed that poor embryo quality is the main culprit. However, this view…
Embryos & Genetic Testing Jan 29, 2024

Multiple failures after live birth from IVF

My first FET in 2020 was successful and resulted in the birth of my son. Since 2022, I have had four more FETs: the first one failed to implant and the next three implanted but miscarried between 5-6 weeks. The… — Kelsey H.

Dr. Geoffrey Sher answered

Implantation dysfunction is often overlooked as a significant reason for IVF failure. This is especially true when IVF failure is unexplained, or when there are recurring pregnancy losses or underlying issues with the uterus, such as endo-uterine surface lesions, thin uterine lining (endometrium), or immunological factors. IVF success…
Embryos & Genetic Testing Jan 29, 2024

DQ-Alpha match & positive receptiva post lap

I hope you can advise me on the situation below. I had Pregmune testing completed in January 2023. It showed my husband and I have DQ alpha match: DQ Alpha - full match, DQ Beta - partial match, HLA-DRB1 -… — Vilma C.

Dr. Geoffrey Sher answered

From your description, it certainly sounds as if your failures are due to an implantation dysfunction...likely, an immunologic implantation dysfrunction (IID). If so, then you MUST have a concommitant natural killer cell activation (NKa). Even though endometriosis can result in an autoimmune IID, and a matchibng D alpha…

Ask Our Doctors

Supporting Your Journey

Our Medical Directors are outstanding physicians that you will find to be very personable and compassionate, who take care to ensure that you have the most cutting-edge fertility treatments at your disposal. This is your outlet to ask your questions to the doctors.

226 answers

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